Limits...
Impact of mass distribution of free long-lasting insecticidal nets on childhood malaria morbidity: the Togo National Integrated Child Health Campaign.

Terlouw DJ, Morgah K, Wolkon A, Dare A, Dorkenoo A, Eliades MJ, Vanden Eng J, Sodahlon YK, ter Kuile FO, Hawley WA - Malar. J. (2010)

Bottom Line: Rainfall patterns were comparable in both years.The overall prevalence of moderate to severe anaemia (Hb<8.0 g/dL) was reduced by 28% (prevalence ratio [PR] 0.72, 95% CI 0.62-0.84) and mean haemoglobin was increased by 0.35 g/dL (95% CI 0.25-0.45).The effect was predominantly seen in children aged 18-59 months and in the two southern districts: PR (95% CI) for moderate to severe anaemia and clinical malaria: Yoto 0.62 (0.44-0.88) and 0.49 (0.35-0.75); Ogou 0.54 (0.37-0.79) and 0.85 (0.57-1.27), respectively.Similar reductions occurred in children<18 months in Ogou, but not in Yoto.

View Article: PubMed Central - HTML - PubMed

Affiliation: Child and Reproductive Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK. d.j.terlouw@liv.ac.uk

ABSTRACT

Background: An evaluation of the short-term impact on childhood malaria morbidity of mass distribution of free long-lasting insecticidal nets (LLINs) to households with children aged 9-59 months as part of the Togo National Integrated Child Health Campaign.

Methods: The prevalence of anaemia and malaria in children aged zero to 59 months was measured during two cross-sectional household cluster-sample surveys conducted during the peak malaria transmission, three months before (Sept 2004, n=2521) and nine months after the campaign (Sept 2005, n=2813) in three districts representative of Togo's three epidemiological malaria transmission regions: southern tropical coastal plains (Yoto), central fertile highlands (Ogou) and northern semi-arid savannah (Tone).

Results: In households with children<5 years of age, insecticide-treated net (ITN) ownership increased from <1% to >65% in all 3 districts. Reported ITN use by children during the previous night was 35.9%, 43.8% and 80.6% in Yoto, Ogou and Tone, respectively. Rainfall patterns were comparable in both years. The overall prevalence of moderate to severe anaemia (Hb<8.0 g/dL) was reduced by 28% (prevalence ratio [PR] 0.72, 95% CI 0.62-0.84) and mean haemoglobin was increased by 0.35 g/dL (95% CI 0.25-0.45).The effect was predominantly seen in children aged 18-59 months and in the two southern districts: PR (95% CI) for moderate to severe anaemia and clinical malaria: Yoto 0.62 (0.44-0.88) and 0.49 (0.35-0.75); Ogou 0.54 (0.37-0.79) and 0.85 (0.57-1.27), respectively. Similar reductions occurred in children<18 months in Ogou, but not in Yoto. No effect was seen in the semi-arid northern district despite a high malaria burden and ITN coverage.

Conclusions: A marked reduction in childhood malaria associated morbidity was observed in the year following mass distribution of free LLINs in two of the three districts in Togo. Sub-national level impact evaluations will contribute to a better understanding of the impact of expanding national malaria control efforts.

Show MeSH

Related in: MedlinePlus

Crude prevalence of parasitaemia in the 3 districts, presented by age group and survey for any parasitaemia and parasitaemia ≥5000/μL.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2914062&req=5

Figure 4: Crude prevalence of parasitaemia in the 3 districts, presented by age group and survey for any parasitaemia and parasitaemia ≥5000/μL.

Mentions: In the central district of Ogou, with the long, stable rainy season, and 43% of the children reportedly sleeping under ITNs in 2005, substantial differences were observed across most of the anaemia and malaria indicators. Comparable reductions among both children below and over 18 months of age (Table 4, Figure 3, Figure 4 and Figure 5), resulted in a pooled 50% and 42% reduction in prevalence of moderate to severe anaemia and clinical malaria, respectively, in children below five years of age with an increase of 0.6 g/dL in mean haemoglobin level. Little or no change was observed in parasite infection levels.


Impact of mass distribution of free long-lasting insecticidal nets on childhood malaria morbidity: the Togo National Integrated Child Health Campaign.

Terlouw DJ, Morgah K, Wolkon A, Dare A, Dorkenoo A, Eliades MJ, Vanden Eng J, Sodahlon YK, ter Kuile FO, Hawley WA - Malar. J. (2010)

Crude prevalence of parasitaemia in the 3 districts, presented by age group and survey for any parasitaemia and parasitaemia ≥5000/μL.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2914062&req=5

Figure 4: Crude prevalence of parasitaemia in the 3 districts, presented by age group and survey for any parasitaemia and parasitaemia ≥5000/μL.
Mentions: In the central district of Ogou, with the long, stable rainy season, and 43% of the children reportedly sleeping under ITNs in 2005, substantial differences were observed across most of the anaemia and malaria indicators. Comparable reductions among both children below and over 18 months of age (Table 4, Figure 3, Figure 4 and Figure 5), resulted in a pooled 50% and 42% reduction in prevalence of moderate to severe anaemia and clinical malaria, respectively, in children below five years of age with an increase of 0.6 g/dL in mean haemoglobin level. Little or no change was observed in parasite infection levels.

Bottom Line: Rainfall patterns were comparable in both years.The overall prevalence of moderate to severe anaemia (Hb<8.0 g/dL) was reduced by 28% (prevalence ratio [PR] 0.72, 95% CI 0.62-0.84) and mean haemoglobin was increased by 0.35 g/dL (95% CI 0.25-0.45).The effect was predominantly seen in children aged 18-59 months and in the two southern districts: PR (95% CI) for moderate to severe anaemia and clinical malaria: Yoto 0.62 (0.44-0.88) and 0.49 (0.35-0.75); Ogou 0.54 (0.37-0.79) and 0.85 (0.57-1.27), respectively.Similar reductions occurred in children<18 months in Ogou, but not in Yoto.

View Article: PubMed Central - HTML - PubMed

Affiliation: Child and Reproductive Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK. d.j.terlouw@liv.ac.uk

ABSTRACT

Background: An evaluation of the short-term impact on childhood malaria morbidity of mass distribution of free long-lasting insecticidal nets (LLINs) to households with children aged 9-59 months as part of the Togo National Integrated Child Health Campaign.

Methods: The prevalence of anaemia and malaria in children aged zero to 59 months was measured during two cross-sectional household cluster-sample surveys conducted during the peak malaria transmission, three months before (Sept 2004, n=2521) and nine months after the campaign (Sept 2005, n=2813) in three districts representative of Togo's three epidemiological malaria transmission regions: southern tropical coastal plains (Yoto), central fertile highlands (Ogou) and northern semi-arid savannah (Tone).

Results: In households with children<5 years of age, insecticide-treated net (ITN) ownership increased from <1% to >65% in all 3 districts. Reported ITN use by children during the previous night was 35.9%, 43.8% and 80.6% in Yoto, Ogou and Tone, respectively. Rainfall patterns were comparable in both years. The overall prevalence of moderate to severe anaemia (Hb<8.0 g/dL) was reduced by 28% (prevalence ratio [PR] 0.72, 95% CI 0.62-0.84) and mean haemoglobin was increased by 0.35 g/dL (95% CI 0.25-0.45).The effect was predominantly seen in children aged 18-59 months and in the two southern districts: PR (95% CI) for moderate to severe anaemia and clinical malaria: Yoto 0.62 (0.44-0.88) and 0.49 (0.35-0.75); Ogou 0.54 (0.37-0.79) and 0.85 (0.57-1.27), respectively. Similar reductions occurred in children<18 months in Ogou, but not in Yoto. No effect was seen in the semi-arid northern district despite a high malaria burden and ITN coverage.

Conclusions: A marked reduction in childhood malaria associated morbidity was observed in the year following mass distribution of free LLINs in two of the three districts in Togo. Sub-national level impact evaluations will contribute to a better understanding of the impact of expanding national malaria control efforts.

Show MeSH
Related in: MedlinePlus